Tuesday, March 22, 2011

Everyone living in our modern world experiences stress, and if our ability to adequately control it diminishes so does our ability to get a good night’s sleep. Sleep time allows repair and recovery to occur, both mental and physical. The inability to recover from chronic stress can increase stress-related eating habits with a subsequent accumulation of abdominal fat on the one hand, and lead to physical and emotional exhaustion on the other. In fact, the deprivation of sound sleep is a common complaint that is associated with a lack of energy. Energy deficits can lead to a diminished immune response. So we see a host of common complaints that can be at least partially attributed to a lack of sleep and the causes thereof.

The lack of a good night’s sleep can be related to a lack of melatonin; a natural hormone made from the amino acid l-tryptophan and its metabolite 5-HTP. Melatonin is formed from serotonin, a metabolite of 5-HTP that is made in the pineal gland during darkness…this means that falling asleep in a bright room, or in front of the TV, may leave one less than fully engaged in sleep and its several stages of healthy brain waves that allow true relaxation to occur. Melatonin is also an antagonist of the aforementioned stress hormone cortisol, and so adequate darkness/sleep/melatonin production is a key factor in controlling chronic stress and its negative effects on the body.

The adrenal glands help the body respond and adjust to stress generated from both internal and external forces. Under chronic stress, cortisol can be overproduced, resulting in weight gain and difficulty in managing healthy blood sugar levels. Adaptogenic herbs help the body to manage the negative effects of stress, such as excess abdominal fat deposition, overeating, and low energy levels.

We see specific sleep solutions that are targeted to enhance certain normal mechanisms; for example, to reduce cortisol and/or increase melatonin to maintain them within healthy levels. Another strategy is to add certain amino acids that are precursors of relaxing or inhibitory neurotransmitters. And some people prefer to utilize individual herbs, while others prefer to take a formula combining multiple mechanisms.

Kava Kava helps people to relax but does not act as a strong sedative. Kava has been used by people to stay calm before taking a test and may support mental focus and calmness.

The essential mineral Magnesium has long been used, sometimes with Calcium, to relax muscles. Magnesium also has an effect to relax overstimulated brain neurons by acting against those excitotoxic states.

L-Theanine is an amino acid found commonly in green tea. L-Theanine promotes relaxation without the drowsiness or negative side effects associated with some other calming agents. L-Theanine also supports healthy cardiovascular function through this relaxing effect, as well as its antioxidant properties.

L-Tryptophan and 5-HTP products are available in various strengths; make sure that the one you buy has been safety, identity, and potency tested. These amino acids are precursors of the important neurotransmitter serotonin, as well as its metabolite melatonin. Melatonin is used by the body to regulate sleep cycles, as an antioxidant, and as an anti-stress aid; in addition to other wide-ranging health effects on the human body.

Relora® is an all-natural proprietary blend of plant extracts from Magnolia officinalis and Phellodendron amurense herbs that helps to control cortisol. Relora® is a safe, non-sedating formula that can help to alleviate symptoms associated with stress such as nervous tension, irritability, concentration difficulties and occasional sleeplessness. The relaxing effect of Relora® can thereby help to control appetite and prevent stress-related eating, aiding in weight control.

100% pure Essential Oils have long been used for aromatherapy, including some oils known to be relaxing. Whether using these oils to sniff, use with reed or other diffusers, blending into carrier oils (almond, olive, apricot kernel, etc.) for massage, or adding a few drops to bath water or potpourri, many people find some of these powerful oils to be very relaxing. Lavender, Chamomile, Marjoram, and Germanium Oils are especially soothing and relaxing.

Some supplements are safe to take daily; for example, the gentler stress vitamins, Chamomile tea, essential oils used in aromatherapy. It is best to be more cautious with stronger herbal and amino formulas, though there’s no strict rule of thumb on how long to take them. Chronic stress may need to be dealt with for many months, resisting a quick fix. On the other hand, one can often cut the melatonin dose down after a month or two of resetting the sleep cycle.

People may not sleep due to a number of factors, and their individual stressors makes it more difficult to figure out which products may help them to normalize their sleep and minimize their stress. Matching the person to the solution is always the biggest challenge, and some trial and error may need to be factored in before a solution is found.

For some products, like melatonin, chewables and liquids may be popular. For herbal formulas, capsules and liquids dominate, but we find that the chewables and capsules sell best for melatonin. Aminos tend to be in powders, chewables, and capsules, with the occasional tablet form.

Sometimes obvious things like limiting caffeine, setting nighttime winding down rituals, and creating a calm space for sleep can be helpful.

A normal piece of fruit may have hundreds of ORAC units, a laboratory measure of antioxidant activity in a test tube. A “superfruit” may have tens of times higher antioxidant activity than our common fruits. Part of the reason for this is the environmental conditions of superfruits: some of them come from rainforests; others from more arid regions. It has been shown in studies that plants make antioxidants in response to environmental challenges such as droughts, variations in nutrient availability, competition with weeds, attacks by molds or bugs, lack of or excess sunlight, and other substandard conditions that are less common in modern chemical agricultural farming. This makes non-conventional crops more nutritious, especially in antioxidant nutrients like polyphenols that have only been compared to conventional crops for about a decade.

ORAC units, being a measure of test tube activity, may not be an ideal way to measure antioxidant potential in a food. However, it does give us a comparative measure of antioxidant compounds in various foods. The fact that these numbers may not accurately reflect their ability to act as antioxidants in the human body has become an issue, but until we get a better measure, or determine exactly which compounds measured by ORAC are used in what ways, this imperfect method still gives us a useful yardstick for nutritional density related to the foods’ antioxidant potential.

Naturally, numerous factors will affect the price and availability of superfruits including long supply chains, weather, transport costs, supply-and-demand, etc. Several superfruits are predicted to have an enduring market presence: Acai, Goji, Mangosteen, Noni, and Pomegranate. Maqui berries possess among the highest known ORAC value (Oxygen Radical Absorption Capacity) of any superfruit. Maqui berries are purple berries rich in anthocyanins.

It’s important to realize that rainforest fruits play a role in preserving tropical rain forests. If the indigenous people can make a living by harvesting wild fruit from mature trees, rather than finding it advantageous to clear cut to farm corn and soybeans, you can see that their vested interest would lie in protecting that forest from developers. Wildcrafted fruit would tend to be more nutritious in antioxidants than orchard-grown fruit, based on the results of comparative studies showing that environmental diversity protects and challenges the plants to produce protective phytochemicals that serve as human nutrients. Of course, these superfruits are not necessarily locally sourced, but they are extremely nutritious and do help to preserve the rainforests.

It’s important to note that the federal government refuses to recognize “structure-function” claims made on foods, which do not have DSHEA protections. You’ve probably heard that food companies touting the benefits of their own superfoods – cherries, fortified OJ, probiotics, pomegranate juice – have been targeted by federal agencies enforcing their rules that all food claims go through the tedious approval process of publishing in the Federal Register, etc. In this regard one can make more claims on a dietary supplement label – if properly documented – than on a food label.

Tuesday, March 15, 2011

Iodine (I) is a mineral that is essential to human health, which we use to make the thyroid hormones thyroxine (T3) and triiodothyronine (T4). These hormones regulate our metabolism, synthesis of protein, enzymatic activity, and other biochemical reactions. They are also essential to unborn children’s and infants’ development of skeletal and nervous systems. Iodine deficiencies cause goiter; an enlargement of the gland. In addition to thyroid functions, iodine has a role in immunity, including breast health. [1]

How do we absorb iodine?

The element iodine is a gas, but we ingest it as a solid salt and that compound is known as iodide. For example, the potassium salt form of iodine is known as potassium iodide (KI). Iodine readily absorbs (about 96%) in the upper intestine (stomach and duodenum). [1]

How much iodine should we normally have?

Of the 15-20 mg present in a healthy adult, 70-80% is stored in the thyroid gland. Excess iodine is excreted in the urine. These iodine concentrations are considered adequate in urine samples:

• 100–199 mcg/L in children and adults
• 150–249 mcg/L in pregnant women
• Over 100 mcg/L in lactating women

Values lower than 100 mcg/L in children and non-pregnant adults indicate insufficient iodine intake, and urinary iodine levels lower than 20 mcg/L are considered severe deficiencies.

Typically, mountainous areas and areas subject to flooding have lower soil levels of iodine. Cruciferous vegetables are goitrogenic (inhibit the thyroid’s absorption of iodine), as are deficiencies of vitamin A or iron.

It takes numerous grams (one gram = 1,000 mg or 1,000,000 mcg) of iodine to cause overt toxicity, though side effects are possible at lower amounts. As with some other vitamins and minerals, symptoms of excess mimic those of deficiency. For iodine, these include goiter, elevated thyroid stimulating hormone (TSH) from the pituitary gland, and hypothyroidism (low thyroid function).

This table from the Institute of Medicine lists maximum recommended levels of supplemental iodine. These levels reflect a comfortable safety margin and few people would have side effects from taking iodine up to the amounts shown. In the event of a radiation emergency, higher amounts may be recommended by public health authorities.
Table 3: Tolerable Upper Intake Levels (ULs) for Iodine [2]

Radioactive iodine-129 (I-129) and iodine-131 (I-131) are produced by the fission of uranium atoms during the operation of nuclear reactors. Iodine-129 is also formed as a result of nuclear weapon explosions, the source of most of the radioactive iodine in our environment. [1]

How is radioactive iodine dangerous to human and animal health?

The body uses both normal (“stable”) and radioactive iodine, not being able to distinguish between them. Radioactive iodine can cause thyroid problems, yet it is also used to help diagnose and treat certain thyroid problems. Long-term exposure to radioactive iodine can cause nodules or cancer of the thyroid, but treatment with high doses of I-131 (the rapidly decaying one) may be used to treat thyroid cancer. Doctors also use lower doses of I-131 to treat overactive thyroids. [1]

How long is radioactive iodine dangerous?

While iodine-129 persists in the environment for millions of years, iodine-131 has a half-life (the time it takes for it to decay to 50% of the original amount) of only 8 days and will decay completely within months. Radioactive iodine is water soluble and can be ingested by drinking it in contaminated water, inhaling it as an airborne gas, eating produce that has it on the surface, eating fish that have absorbed it from the water, or from consuming milk or meat from animals that have eaten plants exposed to radioactive iodine. While iodine mainly collects in the thyroid gland, where it has a half-life of about 100 days, there are iodine receptors in other parts of the body - such as bone, kidney, spleen, and reproductive organs – where it has much shorter half-lives. [1]

What do public health authorities recommend to limit absorption of radioactive iodine?

In emergencies large doses of stable iodine are used to flood the bloodstream to help prevent the thyroid gland from taking up radioactive iodine, since raising the concentration of stable iodine in circulation would make it far less likely that the gland will absorb much radioactive iodine. These very high doses of stable iodine are not intended for daily use and may be hazardous for some people. [1]

What are good sources of stable iodine?

High dose potassium iodide in pills or capsules is the form given when public health authorities distribute iodine to populations at risk of radiation exposure.

Seafood, including fish and seaweed, and dairy products (due to fortified feed and iodine-based sanitation products used in milking, but the use of both of these are reportedly on the decline) provide significant amounts of stable iodine in the diet, but not enough to block the entry of radioactive iodine into the thyroid gland when an emergency is present.

Seaweeds have a flaw in that they typically contain less that 1% iodine by dry weight and also may contain undesirable heavy metals that are considered safe at recommended levels. In other words, don’t rely on kelp or dulse for much more than the RDA, or at most the UL (see above), because the levels of arsenic or other metals might also rise enough to become potential health hazards.

Iodized salt also provides essential iodine that can compete with radioactive iodine; a 1.5 gram serving (about ¼ teaspoon) provides about 71 mcg of iodine. Processed foods rarely use iodized salt, which must be declared on the label. However, there is only enough iodine in iodized salt to nourish the thyroid gland, not enough to exclude radioactive iodine from entering and causing harm. [1, 3]

Large doses of stable iodine reportedly protect the thyroid from accumulating radioactive iodine by competitively excluding that form because the thyroid is already full of stable iodine.

How much iodine should I take, and when?

“According to the FDA, the following doses are appropriate to take after internal contamination with (or likely internal contamination with) radioactive iodine:

•Adults should take 130 mg (one 130 mg tablet OR two 65 mg tablets OR two mL of solution).
•Women who are breastfeeding should take the adult dose of 130 mg.
•Children between 3 and 18 years of age should take 65 mg (one 65 mg tablet OR 1 mL of solution). Children who are adult size (greater than or equal to 150 pounds) should take the full adult dose, regardless of their age.
•Infants and children between 1 month and 3 years of age should take 32 mg (½ of a 65 mg tablet OR ½ mL of solution). This dose is for both nursing and non-nursing infants and children.
•Newborns from birth to 1 month of age should be given 16 mg (¼ of a 65 mg tablet or ¼ mL of solution). This dose is for both nursing and non-nursing newborn infants.
A single dose of KI protects the thyroid gland for 24 hours. A one-time dose at the levels recommended in this fact sheet is usually all that is needed to protect the thyroid gland. In some cases, radioactive iodine might be in the environment for more than 24 hours. If that happens, local emergency management or public health officials may tell you to take one dose of KI every 24 hours for a few days. You should do this only on the advice of emergency management officials, public health officials, or your doctor. Avoid repeat dosing with KI for pregnant and breastfeeding women and newborn infants. Those individuals may need to be evacuated until levels of radioactive iodine in the environment fall.” [3]

Taking a higher dose of KI, or taking KI more often than recommended, does not offer more protection and can cause severe illness or death.

When public health or emergency management officials tell the public to take KI following a radiologic or nuclear event, the benefits of taking this drug outweigh the risks. This is true for all age groups. Some general side effects caused by KI may include intestinal upset, allergic reactions (possibly severe), rashes, and inflammation of the salivary glands.

When taken as recommended, KI causes only rare adverse health effects that specifically involve the thyroid gland. In general, you are more likely to have an adverse health effect involving the thyroid gland if you

•take a higher than recommended dose of KI,
•take the drug for several days, or
•have pre-existing thyroid disease.

Newborn infants (less than 1 month old) who receive more than one dose of KI are at particular risk for developing a condition known as hypothyroidism (thyroid hormone levels that are too low). If not treated, hypothyroidism can cause brain damage. Infants who receive KI should have their thyroid hormone levels checked and monitored by a doctor. Avoid repeat dosing of KI to newborns.

Limitations of large dose stable iodine [3]

• Stable iodine may protect the thyroid if taken at the right time and at a high dose. However, it is not proven to protect other parts of the body and stable iodine does not block the radioactive form from the body.
• That limited protection for the thyroid from taking high dose stable iodine only lasts for about 24 hours.
• Stable iodine does not protect the body from any other radioactive materials that may be in the environment.

Final thoughts

People in other countries, such as the United States, will not experience the amount of radiation that those in the immediate vicinity of the nuclear plants could. Since the high-dose potassium iodide (KI) works to protect the thyroid gland only for about 24 hours, it is probably wise to wait for a specific event to actually take that pill. Meanwhile, a reasonable daily dose of iodine within tolerable upper limit (UL) levels (between 200-1,100 mcg; see above) is probably wise to maintain some level of protection against potential low level increases in airborne radioactive iodine and to assure adequate levels in the thyroid so it’s not so anxious to take in whatever form is circulating in the body and there is plenty of the stable form available. High-dose seaweeds like kelp and dulse may also provide heavy metals in excess of safety recommendations and should only be taken at levels closer to the RDA.

Monday, March 07, 2011

The awareness of EFAs, especially the Omega-3 fatty acids EPA and DHA, is large and growing larger. The accumulating mountain of evidence and the endorsement by popular health “gurus” assures continued growth in this important product category. As the benefits of specific fatty acids for regulation of various healthy body functions – such as inflammatory processes, hormonal health, and maintaining brain/nerve/cellular structures – becomes even more well known, more and more people recognize the potential for EFAs to positively affect their health.

While there are combination products that deliver Omega-3, Omega-6, and Omega-9 fatty acids together, the focus has been more on specific sources such as fish or flax, along with some more unusual ones. Of course, natural oil sources are not comprised of a single fatty acid. For example, natural fish oil can not only supply EPA and DHA but also originally supplies ALA, cholesterol, triglycerides, and other fatty acids; though many of these components can be removed during processing to provide purer and stronger materials that are richer in EPA and DHA to require far fewer capsules to reach desired levels of these two fractions. Flax oil is best known as a vegetarian source of the omega-3 fatty acid ALA (alpha-linolenic acid), but ALA levels are only about 55% of the total; flax oil also contains about 19% omega-9 as oleic acid, 14% omega-6 as linoleic acid, and 12% saturated fats. The conversion of ALA to EPA is a significant metabolic hurdle. Women do this conversion better than men; people who consume the most omega-6 in their diets have a more difficult time converting ALA to EPA. Typically between 5% and 15% of ALA converts to EPA and about 2% to 5% of ALA converts to DHA, making flax a much more dilute and less certain source of EPA-DHA.

Fish oil is subject to environmental concerns related to both sustainability and contaminants. Manufacturers audit their suppliers and set strict identity/safety specifications to assure the quality of products.

Most fish oils are molecularly distilled to remove contaminants, manufactured under strict quality assurance standards, and screened to be free of potentially harmful levels of contaminants and heavy metals, such as mercury, PCB’s, dioxins, and others.

The trend is toward more concentrated products of higher purity that allow people to get their EPA and DHA with smaller quantities of capsules or less volume of liquid. Liquids and smaller capsule sizes allow more children and seniors to enjoy the benefits of fish oils, while high strength capsules better hit the main demographic in between.

All fish oil supplements are typically hundreds of times safer than eating a serving of fish in relation to environmental factors; and typical esterified products have the added benefit of being free of cholesterol and triglycerides, which are undesirable food components for those with high cholesterol. By far, most of the studies proving the health benefits of supplemental fish oils have been with the esterified (ethyl ester) form, rather than the triglyceride form found in cold water fatty fish. There is very strong science supporting the use of this form.

Esterified fish oils also have been shown to sustain human serum levels better than the triglyceride form, over both a 24-hour period and a one-month period, which better supports a healthy heart rhythm. Notably, the most concentrated products are available only as esterified fatty acids. The ability of a consumer to get the 1-3 grams daily of EPA + DHA recommended by many health experts is enhanced by modern formulas that concentrate these essential fatty acids into fewer capsules and smaller serving sizes with fewer undesirable components, thus increasing customer compliance with a healthy nutritional protocol.

Both triglyceride and esterified ethyl ester fish oils are available in the marketplace, and both forms have their advocates. In the body, both forms must first be digested, stripping off the triglycerides or ethyl esters and leaving only free fatty acids that can be readily absorbed. These free fatty acids are then combined with triglycerides present in the liver before entering general circulation; so the circulating form will actually be the triglyceride form, no matter which form of fish oil one consumes. Both forms provide great value and important nutrients for the consumer; but the triglyceride form has no more proven value than the ethyl ester form, despite some excessive marketing claims.

Weight management products have long been an important category for natural product retailers, partially because it is such a problem for many people to control their weight but also since many people shop in these stores because they want to use natural products that are free of potentially risky pharmaceuticals. As a gateway category for transitional shoppers that may be new to health food stores, weight management products become an important gauge of a commitment to meeting these people’s needs and thus keeping them as customers willing to try other products. Of course, nutritionists will suggest a comprehensive diet and supplement plan, rather than relying on “magic bullet” single products.

Good Manufacturing Practices (GMP) regulations have gone into effect over the past several years, raising the bar on manufacturers’ quality control practices. At the same time, mandatory Adverse Event Reporting (AER) was also implemented. Both of these regulatory mechanisms should increase consumer confidence and belie the myth that the industry is “unregulated”.

I believe that the glut of stories about Americans being overweight tends to make people more aware of their own lack of exercise and dietary restraint, which contribute to their excess weight. Of course, health scares and medical crises also alert people to their mortality and tend to motivate healthy dietary and other lifestyle changes. Today’s youth-obsessed media makes people want to look young and fit even past middle age. Plastic surgery, being expensive and with some risks, is far from a perfect solution. There are no shortcuts to health, only natural aids to good health. The very visible failures of both diet drugs and illegal products pretending to be dietary supplements illustrate the depth of the market and the need for effective natural weight management products.

Consumers tend to look for something that was recommended to them, either by a person or an authority. The person could be a family member, co-worker, or an acquaintance. The authority could be someone cited in the media, on the Internet, or a trusted trainer or health professional. Top categories are controlling appetite (satiety), increasing metabolism (thermogenics), and blocking the absorption of certain food components such as carbohydrates or fats (nutrient blockers).

Natural foods and fibers are part of the solution to maintaining healthy weight and blood sugar. These foods would include whole grains as well as fibers from various sources. Some of these fibers are gluten-free and/or organic, such as Flax, Acacia, Inulin, and Psyllium. Fibers also help satiety, the feeling of being full.

Consumers today are more concerned about the quality and safety of diet support products, so are looking for assurances of adequate quality controls and testing. Some parts of this process include method validation and development, stability testing, identity testing, microbiological testing, heavy metal testing, specification development, overseeing production, procuring samples and preparing them for testing, and even raw material vendor audits.

Friday, March 04, 2011

A study found that about 1/4 of all otherwise normal infants have evidence of infantile rickets while still in the womb. It is likely that tens of thousands of infants are being sent home from the hospital with multiple fractures because no one has ever done a study looking for asymptomatic fractures.

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About Me

Neil E. Levin, CCN, DANLA is a nationally board-certified clinical nutritionist with a Diplomate in Advanced Nutritional Laboratory Assessment. He is a professional member of the International & American Associations of Clinical Nutritionists.
Neil is a nutrition educator and a dietary supplement formulator.
Neil is a member of the Scientific Council of the national Clinical Nutrition Certification Board and is on the board of directors of the Mid-American Health Organization (MAHO). In July, 2008, Neil was named an National Products Association "Industry Champion," "an award given to people who have made notable individual contributions to industry above and beyond what is expected to achieve commercial success".
Neil is the immediate past president of the American Nutrition Association (americannutritionassociation.org).
Neil is frequently published or quoted in magazines and newspapers, and has been interviewed on many radio and television news programs. Follow him on Twitter: neilelevin
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